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					CONTROL

McFarland & Miller (1994) examined the way personality affected the way social
information was used. For their social information, non-depressives and optimists
focussed on people who performed worse than they did, whereas depressives and
pessimists focused on people who performed better than they did.

Carver et al. (1989) argues that the distinction between problem-focused and emotion
focused coping is too simple as more factors need to be involved.

“Copology” (Hughley, 1994) is the study of how people cope with aversive life events
and the associated stress they endure.

        Borrowing from the conceptual framework of Heckhausen & Schulz (1995), the
individual considers the value of undertaking an action (predecisional motivation), they
then decide when and where to act (preactional volition), and they then act (actional
volition). Afterwards, outcomes are evaluated through satisfaction appraisals
(postactional motivation).

Thompson et al. (1994) found that SC (in the form of acceptance) was unrelated to
levels of depression for individuals who were HIV+ and who already had strong beliefs
in PC. However, for individuals with weak perceived PC beliefs, high SC was related to
less depression.

Langer & Roth (1975) manipulated the pattern of success in a pure chance task of
predicting coin tosses. Participants receiving feedback that they were consistently
successful early in the task were more likely to see themselves as better on the task
than others, to remember past successes better, and have a greater expectation for
future success. A high level of early success can enhance the illusion of control.
Conversely, a focus upon failure may eliminate the illusion of control.

Emmons, R. A. (1986). Found that several specific characteristics of goals affect PA,
NA, and satisfaction in different ways. PA is associated with past fulfilment of goals;
NA is associated with low perception of being able to achieve future goals. Having
valued goals, independent of past success, was associated with high life satisfaction.

Scheier, M. F., Carver, C. S. (1985). Optimism is the characteristic tendency to expect
favourable outcomes in one’s life. This leads to more successful goal achievements
than for pessimists.

Nolen-Hoeksema, S., Parker, L. E., & Larsen, J. (1994). Rumination on negative
events associated with decreased life satisfaction. The effects of social support were
entirely moderated by rumination in the bereaved adults.

Ackermann, R., & DeRubeis, R. J. (1991). The depressive realism literature is vast.
However, the review of the literature revealed that their was mixed results for support
for depressive realism regarding judgments of contingency. There was a general trend
for moderately depressed persons to be more accurate in their perceptions of control.
It follows that PA can lead to illusory control. Aspects of illness that are subject to
personal control need to be identified.

Brunstein, J. C., Schulteiss, O. C., & Grassman, R. (1998) found that progress that was
made towards only motive-congruent goals was related to SWB, and commitment to
motive-incongruent goals led to a decline in emotional well-being. Hence, it is better to
have goals which are suited to their needs.

Hsee, C. K., & Abelson, R. P. (1991). Found that the rate of progress towards
achieving a goal was more related to levels of affect than goal achievement itself.

Heckhausen, H., & Gollwitzer, P. M. (1987). Suggest that as an individual decides upon
undertaking an activity (the predecisional phase), they make realistic assessments, but
once the decision has been made to undertake a course of actions, they have an
optimistic assessment of abilities and expectancies. Therefore, the more planning that
occurs before a behaviour, the lower the chance of illusions of control.

Brandtstadter, J., & Renner, G. (1990). Propose that adversities in life can be
overcome by changing life circumstances to personal preferences (assimilative coping),
or by changing those preferences and goals to the confines of the situation. Found a
shift to the latter with increasing age.

Partridge, C. J., & Johnston, M. (1989). Found that greater an internal LOC was
associated with faster recovery in individuals disabled by a stroke or wrist fracture.
Proposed that the negative affect associated with an external LOC may compromise
rehabilitation.

Realistic aspirations which are congruent with one’s resources, are the best predictor of
SWB, rather than aspirations per se. Diener, E., & Fujita, F. (1995) found that
resources predicted SWB more strongly when the resources were associated with
one’s goals. Hence if goals are related to money or physical attractiveness, if these
resources are affected, SWB is markedly affected.
Kasser, T., & Ryan, R. M. (1993). It is the context of the aspiration, rather than the
ability to achieve the aspiration, that determines one’s well-being. Intrinsic aspirations,
such as personal growth, were positively related to SWB, but extrinsic goals (eg.,
money), was negatively correlated with SWB.

Lachman, M. E., & Weaver, S. L. (1998). Found that the effects of low income on well-
being was influenced by beliefs in control.

       Concerning gender differences related to strategies of control, Billings & Moos
(1984) found that females were more likely than males to use emotional discharge to
manage aversive situations. This strategy tended to be associated with more
unfavourable outcomes. However, these findings were not supported by Folkman &
Lazarus (1980), who instead found that males were more likely to use problem-focused
strategies in situations requiring acceptance. These tentative findings indicates that
males may tend to use selective PC strategies and females compensatory SC
strategies to manage life events.
        Beliefs in control may also differ across cultures. In the Thompson et al. (1996)
study, white participants from the USA who had a greater amount of perceived PC in
the initial interview, exhibited less psychological distress in a second interview.
However, this was not the case for the African-American participants, who also had
elevated levels of psychological distress in the second interview. In another
demonstration of cultural differences in perceptions of control, Weisz et al. (1984)
report that Japanese respondents tended to emphasise the use of SC strategies, whilst
respondents from the USA tended to place a greater emphasis on PC strategies.


                                           SQOL
Stanton (1998) compared organisational survey data gathered by the traditional “paper
and pencil” format with organisational data obtained via an on-line version on the
internet. Compared to non-internet data, internet data had similar missing values, had
comparable item variability, and demonstrated similar internal covariance patterns
(factors).

Must calculate power apriori - correct sample size, alpha level, error variance less
variance, more power and effect-size treatment effect in order to have sufficient
power, (Olejnik, S. F., 1984) .

Finally, a SQOL measurement is in accordance with the World Health Organisation’s
definition of QOL as “the individual’s perception of his/her position in life in the context
of the culture and value systems in which he/she lives and in relation to his/her goals,
expectations, standards, and concerns” (Orley & Kuyken, 1993; p. 42). This definition
places emphasis on the “perception” that the individual has about different areas in
their lives.

        In order to provide an estimate of the unique variance and the shared variance
between each domain, Cummins (1998) regressed each of the eight domains against
total SQOL scores. The eight domains produced a unique variance of 20-25%,
averaging 2-4% per domain. This means that if respondents were asked to rate levels
of satisfaction with one domain only, then that domain would explain approximately
75%-80% of the variance. According to these figures, a range of between 6 and 13
domains should be able to account for the maximum amount of domain variance.

Due to the cognitive component of satisfaction ratings, such assessments may be more
stable than mood states, but less stable than personality dispositions (Tam, 1998).

Neuroticism is positively correlated with NA and extroversion positively correlated with
PA (Watson & Clark, 1992). Conscientiousness is strongly associated with PA if an
individual experiences success (Watson & Clark, 1992), whereas openness to
experience has been found to be related to both high PA and high NA (Costa & McRae,
1984).

       Finally, ratings of importance within each domain may enhance the accuracy of
SQOL assessments (Cummins, 1996; Felce & Perry, 1995). The benefit of this
approach is that subjective assessments are interpreted in relation to the importance
given to each domain. For instance, if an individual places little importance within a
domain that they may be highly satisfied in, then that domain would have a reduced
contribution to overall SQOL. However, anomolies in computing correct weightings of
the importance/satisfaction quotient eg. an individual who is highly satisfied within a
domain but who places low importance within that domain would score similarly to an
individual who is lowly satisfied but who places high importance within a domain, makes
the appropriateness of this combination requiring further investigation.

As observed by Gill & Feinstein (1994), few studies adequately justify why they chose
to measure QOL the way they did.

Lyubonirsky & Tucker (1998) found that happy people did not differ from unhappy
people in the number of positive or negative events. However, unhappy persons
focused on the negative impact of life events and happy persons judged events as
more positive and reacted to them in more positive ways.

Each system is contained within one somewhat bigger, and depending upon one’s
objectives, a system may contain everything within the known universe, or a portion
thereof (Beer, 1959).

As proposed by Veenhoven (1999), QOL is the condition of the whole ecosystem.

This model is similar to that of Helson’s (1964) adaptation-level theory.

       Cummins (2000) examined 62 distributions of life satisfaction data collected in
15 different countries. It was found that sample means above the normative score of
70%SM were positively related to their standard deviations, with standard deviations
below this score being negatively related to their standard deviations.

       From their own longitudinal research, Headey and Wearing (1992) propose that
equilibrium patterns of SQOL are due to stable personality traits, such as extroversion,
neuroticism, and openness to experience. Accordingly, outside events temporarily
affect SQOL, but over time, stable personality traits cause people to return to similar
levels of life satisfaction.

Social indicators research assesses QOL with regards to the availability of natural,
economic, social, and other resources required to groups of people for the goods and
services needed for better living (Dijkers, 1997a). Such indicators may include GNP,
green-house emissions, and psychologists per capita.

      Satisfaction ratings are useful not only because such ratings have been found to
be stable in unchanging conditions, but also sensitive to changes in various life
circumstances (Headey and Wearing, 1992; Atkinson, 1981).

In support of bipolarity, PA and NA have been found to be inversely correlated with
levels of satisfaction (King et al., 1992).

DeLongis et al. (1988) found that the effects of events on NA (Hassles and Uplifts
Scale, ) was generally restricted to a single day over their six month survey. However,
Sheldon et al. (1996) found that these “negative” days had a carry-over of NA into the
next day. PA and NA may appear to be independent due to the distributions of the
constructs being different.
Data drawn from a large Australian panel (N = 942) were factor analysed by Headey et
al., (1984). Well-being, namely satisfaction with life-as-a- whole, self-fulfilment,
happiness and positive affect, depended more upon the personality traits of
extroversion and optimism, as well as supportive social networks. Ill-being however,
which refers to negative affect, worry, and somatic complaints, was more strongly
related to socioeconomic status, poor health and low scoring on personal competence

Methodological difficulties can occur if satisfaction is not explicitly defined (Williams et
al., 1998).

What QOL means involves continuous investigation (Schwartz & Ben-Menachem,
1999).

There may still be ambiguity. If in a QOL questionnaire it is asked “How many times
during the previous month did you swear in anger?” requires respondents to estimate a
quantity which in itself may be a subjective rating. This suggests that objective QOL
assessments may not necessarily be purely objective.

Frijda (1988) proposes that PA is contingent upon changes in circumstances therefore
may disappear over time. However, NA continues so long as the condition remains.

Using a qualitative interview structure, Williams et al. (1998) examined the process by
which patients may evaluate mental health services in order to reach levels of
satisfaction with that service. The authors surmised little relationship between positive
and negative experiences and evaluations of the service which produced those
experiences. Basically, an individual may not perceive a service to be responsible
(culpable) for an experience, if the individual believe that their experience was not
under the jurisdiction (duty) of the service. They use this framework to explain why
elevated levels of satisfaction ratings with services may be reported. This is where an
individual may be dissatisfied with aspects of a service, but they may feel that the
service was not responsible for that experience as the cause of that experience was not
under jurisdiction of the service. Hence an individual may be dissatisfied with a service
only if they believe that a negative experience was the responsibility of the service.
There may therefore be high ratings of satisfaction for a service even if they have had
negative experience with they service.

Williams et al. (1998) propose that in order to assess the effectiveness of health
services, it is not enough to measure satisfaction with that service, but to also assess
experiences (events) and meanings put upon those events with that service.
Nonetheless, levels of dissatisfaction may be used as a benchmark for minimum levels
of negative experiences.

This definition is in accordance with Felce and Perry (1995), who from their research
deduced that QOL “integrates objective and subjective indicators, collectively reflecting
a broad range of life domains, through an individual ranking of the relative importance
of each domain”(p.69).
       There are complicating factors in the heritability debate. Diener et al. (1999)
point out that monozygote twins may or may not share the placentas in utero, which
may affect their similarity. Or the genetic effects on SWB may not be direct, as
genetics may influence behaviours which influence life events. Hence “heritability
estimates do not inevitably point to unchangeable predispositions to experience
emotions” (p. 6). The size of the influence of genetics of SWB can vary markedly.

Costa & McRae (1980) found that levels of PA and NA were related more to personality
characteristics rather than environmental influences.

Within the general population, independence has been found to be negatively
correlated with levels of depression (Centre for Epidemiological Studies Depression
Scale) (Tweed et al., 1988).

Cummins & Baxter (2000) propose that a more sensitive technique for comparing
SQOL scores between samples, is to compare data from the top three scale values
alone, due to the negative skew in SQOL scores. However, this reduces power, as
around 40% of data may be omitted.

Ellison, C. G., Gat, D. A., & Glass, T. A. (1989). Found that religious variables
accounted for approximately 5 to 7 percent of life satisfaction variance, but only 2 to 3
percent variance in affective-well-being. Proposes that this is because the benefits of
religion is mainly cognitive, where one can interpret one’s experiences. Religion may
not increase or decrease positive or negative events in life.

Diener, E., & Diener, M. (1995). The close relationship between self-esteem and SWB
has been documented. However, these authors found that the relationship was low in
collectivist cultures which value the group above the individual.

Magnus, K., Diener, E., Fujita, F., & Pavot, W. (1993). Used a longitudinal design to
assess the influence of personality on life events. Support Headey and Wearing (1992)
who used a longitudinal design to assess the influence of personality on life events.
They found that extroversion and neuroticism predisposed individuals to experience
positive and negative life events respectively. These life events then influenced SWB
over and above personality. Hence personality can create situations which affect
SQOL.

Emmons, R. A., Diener, E., & Larsen, R. J. (1986). Proposed a complex model of
interactionism which is a “reciprocal, dynamic, transactional, or organismic
interactionism”. This is where both the personality and the environment are
simultaneous independent and dependent variables with bidirectional causality. The
congruence hypothesis is that people choose situations which are congruent with their
personality. However, people were not necessarily happier in situations which suited
their personality.

Lykken & Tellegen’s (1996) heritability estimate of 0.80 is for affect that was stable over
a 10-year period, the stable proportion of SWB accounted for only a moderate
percentage of the variance in SWB responses at either time period. Hence, happiness
can be focused upon at a specific period in life and conclude that heritability has a
moderate influence, or one can focus on people’s average happiness over the long
term and conclude that heritability has a substantial effect. The longer the time period,
the greater the chance of heritability to have an influence.

Pavot, W., Diener, E., & Fujita, F. (1990). There are various reasons why extroverts
experience greater PA than introverts. Conversely, it is possible that the characteristics
of extroverts are due to higher levels of PA. Found that individuals experience greater
PA in social situations than in non-social situations. However, extroverts were more
happier than introverts even when alone, extroverts did not spend more time with
others.


SCI
Missing Data

      A printing error meant that 31 of the 34 Australian participants were not given the
opportunity to rate the importance they placed upon the domain of productivity on the
ComQol. Consequently, the overall mean importance score for productivity was based
upon the data of 47 participants. Due to the even spread of other missing items,
missing data were replaced with the total mean score on each item.

Staff may have feelings of helplessness within themselves if they have difficulty dealing
with patients (Nebesky, 1991).

Nebesky, A. S. (1991). Psychosocial intervention with the treatment team. SCI
Psychosocial Process, Fall, 4-7.

INDIVIDUALS WITH SCI who exercise control are at risk of being misinterpreted as
“non-compliant” by SCI staff (Hulse, 1997).

Hulse, K. L. (1997). Psychosocial health issues for individuals with spinal cord injury.
SCI Psychosocial Process, 10(1), 3-7.


Barone (1993) found that individuals with paraplegia had a greater sense of control
(Derogatis’s Psychological Adjustment to Illness Scale) than persons with quadriplegia.

Barone, S. H. (1993). Adaptation to spinal cord injury. Dissertation Abstracts
International, 54-07B, 3547.

Brickman et al. (1978) found that lottery winners rated winning the lottery as positive as
INDIVIDUALS WITH SCI rated sustaining their injury as negative.

Brickman, P., Coates, D., & Janoff-Bulman, R. (1978). Lottery winners and accident
victims: Is happiness relative? Journal of Personality and Social Psychology, 36(8),
917-927.

In a survey of psychologists from SCI units in the USA, a mean of 24.4% of patients
were reported by Williams & Mourer (1990) as needing psychological and/or psychiatric
treatment during the course of rehabilitation.
Williams, G. N., & Mourer, S. A. (1990). Psychological assessment of newly injured SCI
patients: Survey results. SCI Psychosocial Process, 3(3), 12-15.

In the Krause & Sternberg (1997) study, the effects of age at time of injury, time period,
and time since injury on levels of SQOL, age appeared to have a negative correlation
with various adjustment outcomes. However, the authors report that situational and
environmental factors had more of an affect on an individual’s SQOL than getting older
per se.

Krause, J. S., & Sternberg, M. (1997). Aging and adjustment after spinal cord injury:
The roles of chronological age, time since injury, and environmental change.
Rehabilitation Psychology, 42, 287-302.

As observed by Butt (1998), empirical work regarding evidence of Post Traumatic
Stress Disorder (PTSD) after SCI is meagre. In a study of 16 male veterans with SCI,
McFall (1991) found little evidence of PTSD, whilst Duff (1997) found lower levels of
PTSD in a SCI sample compared to other trauma populations.

Butt, L. (1998). Post-traumatic stress disorder and spinal cord injury: Part 1. SCI
Psychosocial Process, 11(3), 48-51.

Duff, J. S. (1997). The psychological sequelae of trauma following spinal cord injury
(post traumatic stress, intrusion, avoidance, anxiety, depression, self-concept, coping).
Dissertation Abstracts International, 58-04C, 1381.

McFall, M. E. (1991). Post traumatic stress disorder in spinal cord injury patients. SCI
Psychosocial Process, 4(3), 88-92.


The Tennessee Self Concept Scale, which assesses concepts of self in terms of
defensiveness, conflict, confusion, and variability in self-perception, has been used in
several SCI samples. Green et al. (1984) and Mayer & Eisenberg (1982) found that in
sample scored significantly lower than normative groups on Physical Self items. The
Green study found that the SCI sample scored significantly higher than normative
scores on Personal Self, Social Self, and Moral-Ethical Self items. They also found that
self-concept scores were positively correlated with a sense of independence, ability to
drive one’s own vehicle, and ability to live with family or friends rather than in residential
care facilities. Koehler (1989) reports a strongly positive relationship between self-
concept and successful rehabilitation.

Green, B. C., Pratt, C. C., & Grigsby, T. E. (1984). Self-concept among persons with
long-term spinal cord injury. Archives of Physical Medicine and Rehabilitation, 65, 751 -
754.

Koehler, M. L. (1989). Relationship between self-concept and successful rehabilitation.
Rehabilitation Nursing, 14, 9-12.
Mayer, J. D., & Eisenberg, M. G. (1982). Self-concept and the spinal-cord-injured: An
investigation using the Tennessee Self-Concept Scale. Journal of Consulting and
Clinical Psychology, 50(4), 604-605.


Woodward (1995) observed that children with SCI may not receive as much support
from the community as other children with disabilities, due to their prognosis not been
likely to improve.

Woodward, J. R. (1995). Neonatal spinal cord injuries: Characteristics and
consequences. SCI Psychosocial Process, 8(1), 15-19.

Women may be significantly more accepting of their injury than men (Woodrich &
Patterson, 1997). However, Fuhrer et al. (1993) found that females were significantly
more at risk of depression (CES-D) than males. Since depression was also strongly
related to the degree of mobility within the home and the community, and the fact that
females reported being less mobile, this may account for this difference in depression
scores.

Fuhrer, M. J., Rintala, D. H., Hart, K. A., Clearman, R., & Young, M. E. (1993).
Depressive symptomatology in persons with spinal cord injury who reside in the
community. Archives of Physical Medicine and Rehabilitation, 74, 255-260.

Woodrich, F., & Patterson, J. B. (1983). Variables related to acceptance of disability in
persons with spinal cord injuries. Journal of Rehabilitation, 49, 26-30.

According to the “nostalgia effect”, Brickman et al. (1978) found that INDIVIDUALS
WITH SCI rated their past as being significantly more happy than when a control
sample rated their past.

Brickman, P., Coates, D., & Janoff-Bulman, R. (1978). Lottery winners and accident
victims: Is happiness relative? Journal of Personality and Social Psychology, 36(8),
917-927.

Mason (1994) found that participants who sustained SCI through surgery, were more
hopeful (Miller Hope Scale) about their prognosis than persons injured through motor
vehicle accidents.

Mason, T. C. (1994). Hope and coping in spinal cord-injured patients undergoing
rehabilitation. Dissertation Abstracts International, 55-08B, 3568.

Mehnert et al. (1990) found that as income and educational level decreased, the
tendency to view oneself as disabled increased in a sample of individuals with various
disabilities.

Mehnert, T., Krauss, H. H., Nadler, R., & Boyd, M. (1990). Correlates of life satisfaction
in those with disabling conditions. Rehabilitation Psychology, 35, 3-17.

Completeness of injury has been found to be more related to the risk for developing
further medical complications than level of injury (Tate & Forchheimer, 1995).
Tate. D., & Forchheimer, M. (1995). Prevalence and incidence of rehospitalisation after
SCI. SCI Psychosocial Process, 8(2), 67-72.

A link between SQOL and death has been reported in the SCI population. Krause &
Kjorsvig (1992) found that individuals who were generally more satisfied (LSQ) and who
rated their own adjustment as better than others with SCI, were more likely to be alive
after a ?? year period. Unexpectedly, recent medical history was unrelated to mortality
rates.

Krause, J. S., & Kjorsvig, J. M. (1992). Mortality after spinal cord injury: A four-year
prospective study. Archives of Physical Medicine and Rehabilitation, 73, 558-563.

In a doctoral examination of the implications of alcohol abuse on the lives of 64 male
SCI veterans, Hagan (1994) found that alcohol abuse was related to lower acceptance
of disability, lower life satisfaction, and lower current self-rated adjustment (measures
unstated).

Hagan, K. M. (1994). Acceptance of disability, life satisfaction and problemtic alcohol
use among male spinal cord injured veterans. Dissertation Abstracts International, 55-
06B, 2399.


    Psychological       Coping (WCC;
             a
    symptoms            Folkman & Lazarus,
                        1985)
                  b
    Dysfunction         Coping strategy
                        assessment (Billings
                        & Moos, 1981)
    Self ratings of     Coping (Medical
    coping              Coping; Feifel et al.,
                        1987)
    Acceptance of       Coping (WCC;
           c
    illness ; PA &      Folkman & Lazarus,
        d
    NA                  1985)
    Psychological       Coping (WCC;
                e
    symptoms            Folkman & Lazarus,
                        1985)
    Life satisfaction   Self ratings of coping
    (developed by
    authors)
    Proxy ratings of    Coping (WCC;
    coping              Folkman & Lazarus,
                        1985);
                  f
    Depression          Ratings of perceived
                        control & acceptance

a
 Langner 22-item Screening Score (Langner, 1962); b Dysfunction = sum perception of
negative life events, personal physical illness, children’s illness, spouse illness,
negative home environment, family strains, work stressors, and social resources; c
Sickness Impact Scales (Linkowski, 1971); d Bradburn Affect Balance Scale (Bradburn,
1969); e Hopkins Symptoms Checklist (Derogatis et al., 1970);
Mayer & Andrews (1981) interviewed ten persons with quadriplegia who were on
average more than fifteen years post injury. The authors found that two of the
participants stated that their injury had been a major barrier to their life goals. However,
four participants stated that their injury created no major change to their life, with four
reporting a major positive change.

Cognitive Restructuring involves finding positive aspects of an adverse experience.
This results in cognitive reappraisal.

Information seeking involves active searching for information and advice about a
problem and its treatment.

Wish-fulfilling fantasy involves hankering for an aversive event to finish.

Emotional expression involves expressing emotional strain concerning the aversive
event.

Threat minimization involves a conscious decision to put distressing thoughts about the
aversive event aside.

       Using a SCI sample, Krause & Rohe (1998) found that of the “big five”
personality dispositions (Watson & Clark, 1992), only neuroticism and extroversion
(NEO Personality Inventory) were consistently related to emotional distress, life
satisfaction, and adjustment.

The correct timing of psychosocial interventions during rehabilitation is essential
(Mourer & Klemz, 1993).

If out-of-control behaviour is practiced intentionally, then this may provide the
opportunity to exercise control (Huang & Quitoriano, 1992).

Mehnert et al. (1990) measured the general life satisfaction of 675 working-aged
individuals with disabilities in the USA. It was found that individuals and their
aquaintances who differentiated from living with a disabling condition from being
disabled, had higher levels of life satisfaction (measures). The authors propose that
this was because these individuals were able to accurately appreciate the extent to
which they were disabled and take the correct steps to compensate. Hence, avoiding
the negative values associated with a disabled identity.

It was found by Soltz (1998), that a sample of adults with a head injury or SCI coped in
the same average range as the norm sample of adults without a disability. Coping was
operationalised according to the sub-scales of Problem-solving, Seeking social Support,
and Avoidance.

Using the MMPI and Rorschach tests, Mourer (1993) found that in three cases of
INDIVIDUALS WITH SCI who asked to end their lives, all appeared to retain their
decision making capacity and did not appear to be depressed or psychotic.
As stated previously in this paper, proxies have generally been found to underestimate
levels of SQOL of INDIVIDUALS WITH SCI, especially those in the early stages of
rehabilitation.

The positive benefits of providing challenging activities matched with skill levels were
emphasised in work by Csikszentmihalyi & Wong (1991).

In an investigation of mood as a function of day of the week during acute rehabilitation,
Scheidt & Dunn (1997) found little relation between mood intensity with day of the week
rehabilitation centers.

As an indicator of the personal growth that can occur after SCI, Green et al. (1984)
found that INDIVIDUALS WITH SCI had significantly higher Personal Self, Moral-
Ethical Self, and Social Self scores than the general population on the Tennessee Self-
Concept Scale (??).

In an investigation of imagery, stress, and non-compliant behaviour in immobilised
hospital patients with SCI, Stewart (1984) found that through the use of questionnaires,
an interview, observations and hospital records, immobility led to greater imagery, but
not an increase in general stress or non-compliance. However, immobility was related
to greater environmental stress due to personal control and response restrictions.

Frustration, anger, and depression, contentment, and satisfaction, may be common
after SCI (Drew-Cates, 1989).

Through in-depth interviews, it was found by Fusso (1985) that the rules of social
engagement differed between individuals with paraplegia, quadriplegia, and non-injured
persons (more detail).


Nowadays within Australia, the average length of hospitalisation within such units is
currently around four months (Phillips & O’Connor, 1998).


Organs already affected by the ageing process are more affected by the physical
changes that SCI imposes (Maness, 1995),

The pendulum reconstruction of self and identity proposed by Yoshida (1993) posits
that the pendulum swings back and forth between non-disabled and disabled aspects
of self.

From their review of the SCI literature, Frank et al. (1987c) concluded that
psychological variables are more predictive of psychosocial adjustment than
demographic variables.


The Life Satisfaction Index -A (LSI-A; Neugarten, Havighurst, & Tobin, 1961) was
developed mainly to measure morale in older adults. Respondents are asked to
indicate whether they agree, disagree, or are not sure to 20 items relating to the five
dimensions of zest for life, resolution and fortitude, mood tone, positive self-concept,
and congruence between desired and achieved goals. The measure has been found to
correlate highly with other subjective rating measures, even though only three factors
(mood, zest for life, and congruence of goals) have consistently been found (Dijkers,
1997).

In 1994, the mean time since injury for INDIVIDUALS WITH SCI in the USA was
around 20 years (Rodgers & Marini, 1994).

				
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